快速康复外科理念在腹腔镜小肝癌治疗中的应用  

Application of concept of enhanced recovery after surgery in laparoscopic resection of small hepatocellular carcinoma

作　　者：周兵[1] 金珊珊[1] 夏源 ZHOU Bing;JIN Shanshan;XIA Yuan(Department of Hepatobiliary Surgery,Huaian First People＇s Hospital,Nanjing Medical University,Huaian,Jiangsu 223300,Chin)

机构地区：[1]南京医科大学附属淮安第一医院肝胆外科,江苏淮安223300

出　　处：《中国普通外科杂志》2018年第7期834-839,共6页China Journal of General Surgery

摘　　要：目的:探讨快速康复外科(ERAS)理念应用于腹腔镜小肝癌切除术患者围手术期的临床价值。方法:分析2016年1月—2017年12月50例腹腔镜小肝癌切除术患者的临床资料,其中24例围手术期采用ERAS方案(ERAS组),26例围手术期采用传统方案(对照组)。比较两组患者相关临床指标。结果:两组患者术前临床资料具有可比性。与对照组比较,ERAS组术中出血量、手术时间均无统计学差异(均P>0.05),术后肛门排气时间与住院时间明显缩短、住院总费用明显减少、并发症发生率均明显降低(均P<0.05);ERAS组术后1、3、5d的Qo R-15恢复质量评分与C反应蛋白水平均明显优于对照组(均P<0.05)。结论:腹腔镜小肝癌切除术患者围手术期应用ERAS理念可以有效的减轻手术创伤应激、缩短住院时间、降低住院费用、减少手术并发症,从而加快患者的康复。Objective： To investigate the clinical value of using the concept of enhanced recovery after surgery （ERAS） in perioperative management of patients undergoing laparoscopic hepatectomy for small liver cancer. Methods： The clinical data of 50 patients undergoing laparoscopic resection for small liver cancer from January 2016 to December 2017 were analyzed. Of the patients, 24 cases received ERAS protocols during perioperative period （ERAS group） and 26 cases received conventional perioperative treatment （control group）. The main clinical variables between the two groups of patients were compared. Results： The preoperative clinical data of the two groups of patients were comparable. In ERAS group compared with control group, the intraoperative blood loss and operative time showed no significant difference （both P〉0.05）, while the time to postoperative anal gas passage and length of postoperative hospital stay were significantly shortened, the total hospitalization cost was significantly reduced and the incidence of complications was significantly decreased （all P〈0.05）; the QoR-15 scores for recovery quality and C-reactive protein levels on postoperative day 1, 3 and 5 in ERAS group were significantly better than those in control group （all P〈0.05）. Conclusion： Using ERAS concept during perioperative period in patients undergoing laparoscopic hepatectomy for small liver cancer can effectively reduce surgical trauma, shorten hospital stay, reduce hospitalization costs and surgical complications, and thereby accelerate the patient＇s recovery.

关 键 词：肝肿瘤 肝切除术 腹腔镜 快速康复外科 

分 类 号：R735.7[医药卫生—肿瘤]